Welcome to Life Symmetry Chiropractic. Thanks so much for selecting our chiropractic office in Colorado Springs for your care. As a new patient we want to ensure your visit is as pleasant as possible. Before we get started with our chiropractic services, we’ll have you fill out a few simple intake forms.
For your convenience the following paperwork can be printed and filled out ahead of your first visit. This will help the initial visit in the office go a little faster. Thank you!
Patient Demographic/Health History Intake Packet – This gives us information about your current condition and health history. The packet also includes other forms (HIPAA Consent Form & Financial Policy) that you need to sign.
Pediatric Patient Demographic/Health History – This gives us information about pediatric patients (0-6 years old) and their current condition. Please also print off & fill out these forms as well: HIPAA Consent Form, Financial Policy
HIPAA Privacy Notice – This form DOES NOT need to be printed and brought to the office. This is a notice of how the office protects your personal information and how we will use your information to treat your condition and is for your information if you would like a copy.